Comparison of a Web-based Advance Directive to a Standard Advance Directive

University of Pennsylvania

Status: Completed

Conditions: GI Cancer; Thoracic Cancer

Treatments: Other: Standard advance directive; Other: Web platform for advance care planning/advance directive

Study type: Interventional

Funder types: Other

Identifiers

NCT03676426

829211

Details and patient eligibility

About

This study will compare a web-based advance directive to a standard advance directive.

Full description

Patients with GI and thoracic malignancies will be randomized to either a standard paper advance directive or the web advance directive (Ourcarewishes.org). Patients will be approached in the Cancer Center and provided the AD information to complete on their own. They will complete a survey at enrollment and a follow up survey administered by email. The primary endpoint will be proportion with new documentation in the EHR at 8 weeks. Second endpoints will include the change in satisfaction with end-of-life plans, AD acceptability, self-reported rates of completion, self-reported rate of sharing with their preferred surrogate decision-maker, proportion with new documentation of preferred decision-maker in the chart, and qualitative feedback. Patients in both groups will receive follow up reminder emails encouraging them to complete the advance directive.

Enrollment: 90 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (any of the following)

• Pancreatic cancer, any stage except stage 0 (C25),
• NSCLC, stage IIIA or higher (C34),
• SCLC, any stage (C34),
• Colon cancer, stage IIIB or greater (C18),
• Rectal cancer, stage IIB or greater (C21),
• Esophageal cancer (adeno or squamous), any stage (C15),
• Stomach cancer, stage IIB or greater (C16),
• Gallbladder cancer, stage I or greater (C23),
• Cholangiocarcinoma, any stage (C22.1),
• HCC, any stage (no plan for transplant) (C22.0),
• Malignant carcinoid of GI tract, stage IV (C7A.019).

Exclusion criteria:

• Does not have an active patient portal (MyPennMedicine) account,
• Does not use email at least once per month,
• Has already completed a living will,
• Does not speak fluent English,
• Unwilling to be contacted by email,
• Determined to be too ill or inappropriate for participation by patient's oncologist.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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90 participants in 2 patient groups

Web-based AD

Experimental group

Description:

Patients will be encouraged to use the web platform for advance care planning/advance directive to document their care preferences..

Treatment:

Other: Web platform for advance care planning/advance directive

Paper AD

Active Comparator group

Description:

Patients will be given the standard advance directive and encouraged to complete on their own.

Treatment:

Other: Standard advance directive